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赖德尔甲状腺炎导致的危及生命的呼吸道阻塞:一种罕见的呈现和诊断困境
Maria Leonor Guia Lopes1, José Pedro Cidade2,3, Clara Cunha1
1Endocrinology Department, Hospital Egas Moniz, CHLO, Lisbon, Portugal.
Endocrinology, diabetes & metabolism case reports
|July 22, 2024
概括
里德尔甲状腺炎是一种罕见的疾病,可以导致甲状腺迅速扩大和呼吸道阻塞. 这一案例突显了老年患者用支架和葡萄皮质类药物进行成功的非手术治疗.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 里德尔甲状腺炎是一种异常罕见的炎症状况,影响甲状腺.
- 老年患者甲状腺迅速扩大通常会引起对恶性瘤的担忧,使诊断复杂化.
- 这种病例呈现出一种罕见的突发情况,即Riedel甲状腺炎导致了严重的气道压缩.
研究的目的:
- 报告一个独特的里德尔甲状腺炎病例,由于甲状腺扩大而出现急性呼吸困难.
- 为了说明老年患者这种罕见的甲状腺疾病的诊断挑战和成功的非手术治疗.
- 强调考虑甲状腺快速生长的良性原因的重要性,即使在老年人中也是如此.
主要方法:
- 一位81岁的老妇人的详细临床表现,她患有和呼吸困难.
- 诊断成像包括CT扫描来评估甲状腺大小和气道压缩.
- 细胞学和组织学评估以确认里德尔甲状腺炎的诊断.
- 治疗涉及口腔管道输入,机械通风,内支气管支架和全身糖皮质激素.
主要成果:
- 显著的甲状腺扩大导致严重的光环和气管压缩 (最低气管直径7毫米).
- 良性侵袭性纤维性甲状腺炎 (Riedel's thyroiditis) 的诊断在组织学上得到证实,尽管最初怀疑有恶性瘤.
- 顺利的非手术治疗与内支气管支架和葡萄糖皮质类药物,导致呼吸困难的解决.
- 患者在一周内出院,恢复正常活动.
结论:
- 里德尔甲状腺炎可以呈现为急性,具有危及生命的呼吸道损害,特别是在老年人中.
- 非手术治疗,包括支架和葡萄糖皮质类药物,当手术不可行或拒绝时可能是有效的.
- 准确的诊断区分良性和恶性甲状腺扩大是关键的,需要彻底的检查.
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